Men's Health

BRCA Gene Mutation a Cancer Risk for Men

Men who are biologically related to family members who have the BRCA1 and 2 gene mutations typically avoid genetic counseling or testing, a new study finds.

Women who have mutations in the BRCA1 or 2 genes have an increased risk of breast and ovarian cancer.

The findings were published in the Journal of Genetic Counseling.

When men do get counseling or testing, they are less likely than women to pass on the information or to discuss it thoroughly with their family members, according to study author Dr. Mary Daly, at Fox Chase Cancer Center in Philadelphia, PA.

She says this is true even though men who carry these mutations "have a 50 percent chance of passing them on to their children," as well as an increased risk for getting certain cancers themselves.

Most cancers associated with BRCA1 and 2 mutations are seen in women, but men with these mutations are at higher risk for male breast cancer, prostate cancer, pancreatic cancer, and melanoma.

Awareness of Genetics is Low

Consider a daughter with BRCA1 or 2 mutations: she has an estimated risk of 56 to 87 percent of developing breast cancer by age 70, says Dr. Daly, and half of these cancers occur before age 50.

The risk is especially high for people of Ashkenazi Jewish descent, she adds. BRCA mutations have been detected in more than 2 percent of this population.

Dr. Daly, who reviewed several published studies for her report, decided to do the research after finding that most men were not interested in getting genetic counseling or testing, even when family members tested positive for genetic mutations.

"In our experience, counseling family members [with genetic mutations], we deal primarily with women," she notes.

Many men, explains Dr. Daly, are simply unaware of how genetic mutations in the family can affect them and their offspring. Women are also unaware of the importance of men knowing.

"Women [who test positive for genetic mutations] are less likely to tell brothers than sisters," she says. "Even if they tell their brothers, they don't tell them as much."

Counseling for Men, Too

Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society, called Dr. Daly's research "an important study" that "highlights what is a significant issue. I agree men need to know their family history - not just their mother's and father's, but aunts, uncles and cousins.

If men discover that the family includes many cases of breast cancer, especially at a young age, "they should be asking their doctors if they should be tested as well," says Dr. Lichtenfeld.

So, which men should consider genetic counseling? Steve Keiles, president of the National Society of Genetic Counselors, offers this example: If a man's family includes some relatives who have had breast or ovarian cancer before age 40, and tested positive for genetic mutations, he should consider genetic counseling.

He stresses that counseling should be the first step, followed by the decision of whether actual testing is needed. "Maybe a consultation will relieve some anxiety."

Most major medical centers now have genetic counseling services, says Dr. Daly.

Always consult your physician for more information.

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May 2009

Breast Cancer in Men Explained

Breast cancer in men is rare - less than 1 percent of all breast carcinomas occur in men. Consider the latest statistics available from the American Cancer Society:

The American Cancer Society estimates that in 2008 some 1,990 new cases of invasive breast cancer will be diagnosed among men in the US.

Breast cancer is about 100 times more common among women.

Estimates for 2008 also indicate that there will be more than 40,930 deaths from breast cancer in the US (40,480 women, 450 men).

The average age at diagnosis is 67, although men can be affected at any age.

Risk factors may include radiation exposure, estrogen administration, diseases associated with hyperestrogenism, such as cirrhosis or Klinefelter's syndrome, and heavy alcohol intake.

Also, there are definite familial tendencies for developing breast cancer including an increased incidence in men who have a number of female relatives with breast cancer; an increased risk of male breast cancer has been reported in families in which a BRCA2 (Breast Cancer 2) gene mutation has been identified.

This gene is probably responsible for about 10 percent of breast cancers in men.

Infiltrating ductal cancer is the most common tumor type, but intraductal cancer, inflammatory carcinoma, and Paget's disease of the nipple have been described as well.